| NPI | 1306169784 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNE S. CABANILLA Principal Officer 970-586-1090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO 3050) |
| Enumeration Date | 2010-03-12 |
| Last Update Date | 2011-02-11 |